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SESSION: DEVELOPMENTS IN INTERNATIONAL MEDICAL PHYSICS COLLABORATIONS IN AFRICA AND LATIN AMERICA
Status of Medical Physics Collaborations and Projects in Latin America
Sandra Guzmán PhD. Radiotherapy Center of Lima Vice President ALFIM
Introduction Cancer mortalities in LA WHO : Cancer cases in South America are expected to increase by 88 % over the next two decades
It is estimated that by 2035 the greatest growth will occur in Ecuador ( 115% more cases ) and Colombia ( 114% more).
Forecasts are completely discouraging. For the next 20 years, no country will see a drop in the number of incidences and cases leading to mortality. According to the WHO, a total of 430,000 people died in South America as a result of cancer in 2012. By 2035 the regional projection is 883,000 . Brazil is the South American country with the largest number of new cases of cancer. Currently, there are 437,000 which will see a 90% increase.
http://actualidad.rt.com/ciencias/165454-cancer-mortalidad- colombia-ecuador-sudamerica
Introduction RISK OF CANCER AND AGE IN LA
Men (%)
Women Risk
Age
Información tomada del GRUPO ONCOMEDICA (Dr. Luis Barriga)
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Cancer Management Introduction
Objectives . local control . survival . quality of life of patients with CANCER Needs – Radiation Oncologist: 1/250 patients . Facilities No more than 25/30 patients under . Adequate access to medicine treatment by a single physician
. Appropriate Technological Equipment – Physicist: 1/400 patients . Qualified Professionals – Dosimetrist: 1/300 patients – Physics Technology: 1/600 patients – RT Technologist: 2 per unit / 25 pat./day 4 per unit / 50 pat./day – Simulation Technologist: 2 1/500 patients – Maintenance Engineer 1 2 megavoltage unit
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Cancer Management Introduction
Objectives . local control . survival . quality of life of patients with CANCER Needs . Facilities . Adequate access to medicine . Appropriate Technological Equipment Qualified Medical Physicist . Qualified Professionals Increasing the number of qualified MP require establishing a coordinated system of national Education & Training Centers (ETC)
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There is a notable lack of medical physicists in the region, Education and human even in the specialty where they perform most frequently, radiotherapy. Educationresources According to recent estimates, in Latin America more than 900 medical physicist, only radiotherapy, would be required to comply with the recommendations of international scientific and professional organizations. At present, we only have about 500.
400 Medical Physicists are needed in Radiotherapy 1000 Existentes 250 Requeridos 62 110 100 39 12 11 35 9 6 5 290 3 4 3 130 6 10 120 3 72 3 7 58 42 4 39 28 21 14 15 13 16 7 10 8 4 5
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Panama
Colombia
Cuba
Chile Chile Venezuel
Nicaragu
Uruguay
Paraguay Argentina
Bolivia
Salvador
Peru
Costa Costa
Guatemal
Brasil Ecuador
Dom. Dom.
Mexico
Rep
Rica
El El
a
a a
Radiotherapy Medical Physicist needs (2007)
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Education and human Educationresources
License/Degree in Medical Physics
University education in different countries includes training at the university degree level (known in some countries as an undergraduate), leading to a degree (I bacharelado in Brazil) in medical physics. These studies have a duration of 4-5 years and their degrees are awarded by institutions of higher education (universities) recognized by the Ministries (or Secretariats) of Education in each country.
Master’s and doctorate in Medical Physics
The aim is to train skilled professionals, academics and researchers, including: specialty, Master and PhD. The duration of these studies is as follows: specialty - 1-3 years: Master – 1 to 2 years; Doctorate - 2-5 years. Training programs These programs are generally offered by health institutions (hospitals and clinics), called hospital residences, in addition to academic training, including clinical training for medical physicists, in which they acquire the skills and practical skills.
Number of medical physicists
ARGENTINA Education and human 13% Educationresources 13% RD: 20 74% NM: 20 RT:120 MP: 160
License/Degree in Medical Physics Favaloro University University of General San Martin National University of La Plata Master’s and doctorate in Medical Physics University of Buenos Aires Instituto Balseiro Foundation School and Nuclear Medicine ( Bariloche and Mendoza) Training programs Offers 9 seats in radiotherapy and 3 in nuclear medicine annually
Number of medical physicists
Education and human Education resources RD: 63 BRASIL NM: 31 MP: 331 RT:237
License/Degree in Medical Physics
Federal University of Uberlandia Federal University of Sergipe University of Sao Paulo (Riberao Preto) Center University Franciscian Catholic University of Pernambuco Pontifical Catholic University of Sao Paulo Catholic University of Rio Grande do Sul State University of Campinas Federal University of Rio de Janeiro Sao Paulo State University in July mosque filho
Master’s and doctorate in Medical Physics
University of Sao Paulo State University of Rio de Janeiro Radiation Protection and Dosimetry Institute Training programs Offers 17 seats in radiotherapy and 6 in imaging per year
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Education and human RD: 1 Education resources NM: 3 CHILE RT:25 MP: 29
Master’s in Medical Physics University of La Frontera (Temuco) University of Chile University of Tarapacá Pontifical Catholic University of Chile
RD: 14 COLOMBIA NM: 5 RT:50 MP: 69
Master’s in Medical Physics National University of Colombia Pontifical University Javeriana
Education and human Education RD: 2 resources NM: 4 COSTA RT:26 RICA MP: 32 Master’s in Medical Physics University of Costa Rica National University of Costa Rica
RD: 9 NM: 25 CUBA RT:35 MP: 69
Master’s in Medical Physics
Higher Institute of Nuclear Sciences and Technologies Higher Institute of Medical Sciences
Education and human RD: 0 ECUADOR Educationresources NM: 2 MP: 11 RT: 9
Medical 18 Physicist
EL SALVADOR
RD: 27 MEXICO NM: 12 RT: 110 MP: 149
Master’s and doctorate in Medical Physics National Autonomous University of Mexico University of the State of Mexico
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Education and human Education NICAGARUA resources RD: 0 NM: 1 RT: 2 MP: 9
RD: 1 PANAMA NM: 0 RT: 9 MP: 10
Education and human RD: 3 Education NM: 0 PARAGUAY resources RT: 5 MP: 8
RD: 5 NM: 7 RT: 40 PERÚ MP: 52 Master’s in Medical Physics
National University of Engineering Training programs
Offers 2 seats in radiotherapy and 2 in imaging per year
Education and human RD: 0 Educationresources NM: 5 DOMINIC RT: 1 REPUBLICAN MP: 6
License/Degree in Medical Physics Central University of Venezuela Master’s in Medical Physics VENEZUELA Central University of Venezuela MP: 67 Venezuelan Institute for Scientific Research
License/Degree in Medical Physics University of the Republic URUGUAY MP:6
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Distribution of the medical physicists Education and human training centers Educationresources 13% 38% Degree 50% Master Doctorate
Distribution of Medical Physicists in LA Education and human per Country Educationresources Distribution of Medical Physicists in
VENEZUELA LA per areas URUGUAY DOMINIC REPUBLICAN PERU PARAGUAY 14% PANAMA 75% 11% RD: 145 NICARÁGUA NM: 115 MÉXICO RT: 775 HONDURAS HAITI GUATEMALA Series1 EL SALVADOR EQUADOR CUBA MP:1035 COSTA RICA COLOMBIA CHILE BRAZIL BOLÍVIA ARGENTINA
0 50 100 150 200 250 300 350
LATIN AMERICAN NETWORK OF MEDICAL PHYSICS (RELAFIME).
Education and human Education The National University of San Martin (UNSAM ) as Convenor University , resources spearheaded the creation in 2012 of the Latin American Network of Medical Physics .
Convener university National University of San Martin National University of Cuyo Participating universities National University of the Plata University of the Habana - Cuba University of Campinas - Brasil University of the Republic - Uruguay
The integration of Latin America is a basic condition for the full development of its population, and that there is now wide variety of options in academic training of a medical physicist. the challenge is to accept that the path is to recognize those differences. The aim is to facilitate communication between universities that will train human resources in the field of medical physics. This approach is intended to discuss which medical physicist profile will be more useful in our region, how we can work together to achieve equal academic policies which could promote the achievement of some medical physicists as well as allow for mutual recognition skills of medical physicists . www.unsam.edu.ar/fisicamedica
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ALFIM 2013-2016 www.alfim.net Education and human Educationresources
SIMONE KODLULOVICH RENHA PRESIDENT (BRASIL)
SANDRA GUZMÁN CALCINA VICE PRESIDENT (PERÙ) The latinoamerican Association of Medical Physics, founded on July 18,
1984. Its aims are as follows:
Maintain high academic and scientific level, in the implementation and development of physics in medicine. -To Promote the progress of medical physics and sciences ILEANA FLEITAS ESTÉVEZ and related disciplines. -Sponsor conferences, seminars , meetings, symposia , SINDICA (CUBA) conferences and training and specialization.
That's why we created the news magazine and this year we are launching the Latin American journal of medical physics, in order to encourage the publication of research papers in LA. ROSANA AMALIA SANSOGNE SECRETARY (ARGENTINA)
Task Group Reports Translated to Spanish
Education and human With permission of the AAPM, several task group reports have been translated Educationresources to Spanish and are planned to be used for training of future Medical Physicists in LA. The translated documents are intended to facilitate understanding and application of the material in a more effective manner and are not intended to replace the original document(s). a plan to publish the translated version of some of the Task Group Reports in the “Revista ALFIM” is being considered.
PERU
EE.UU
Education and human Content of academic programs Educationresources
Training in Medical Physics in Latin America has been without structure because each country has its own requirements; in other words, there is no standardized program.
In curricula require the development of a thesis to grant the title. Deadlines , formal academic load and the time required for the preparation of the thesis does not allow , in addition , the student can acquire a supervised practical training of
However , some existing Masters include ' residences ' hospital , inspired by the homes of medical students within their activities academic . Generally, these semi residences covering more than one specialty , precisely seeking to provide a first level , as wide as possible , of training or practical clinical knowledge .
It is recognized that the responsibility for maintaining academic standards in college graduate medical physics programs lies with each university , and is guaranteed through accreditation systems of each country
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Clinical training in Medical Physics Education and human Educationresources Clinical training sites with formal programs are very limited
As we observe, clinical training programs are structured around a hospital’s intensive practice called hospital residences in the region (Brazil and Argentina ) . To obtain a hospital residency requires that the applicant have a Bachelor in Physics or Medical Physics , with a background in theoretical courses and hospital practice. Most of the training is for the radiation area and the rest in radiology and / or nuclear medicine.
Accreditation of an academic program
The accreditation of an academic program and / or clinical training is a volunteer process which aims to ensure that the program or institution has reached a defined standard.
Content of academic programs Education and human Proposals Educationresources
Establish common academic programs in both theoretical aspects and practical education for medical physicists to provide a sustainable basis for quality diagnostics and safe treatments ;
There is a proposal to unify the postgraduate academic training and clinical training for the medical physics area within a hospital residency program lasting a minimum of three years .
Whatever the specific method chosen , it must be ensured the minimum content of academic programs and clinical training meet the needs of hospital practice , which should be subject to a accreditation process.
A number of Education & Training Centers (ETC) should be created at each country
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Content of academic programs Education and human Proposals Educationresources We currently have the recommendations outlined in a publication of the IAEA , but there needs to be more concrete actions , for it should be a committee of action for:
The review of existing programs in training medical physicists in Latin America help define , address , implement and monitor changes to occur . This can be given with the support of organizations such as
AAPM, CAMPEP, WHO, IAEA ABR, SDAMP
CAMPEP Accredited Programs in Medical Physics
1. Accredited Graduate Programs in Medical Physics
2. Accredited Degree Programs (MS, Ph.D)
3. Accredited Certificate Programs in Medical Physics
4. Accredited Residency Programs in Medical Physics 24
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ARGENTINA Argentinian Society of Medical Physics (SAFIM) Medical Physics BRASIL Brazilian Association of Medical Physics (ABFM) OrganizationsEducation CHILE Medical Physics Society of Chile (SOFIMECH)
COLOMBIA Colombian Asociación of Medical Physics and Radiation Protection (ACOFIMPRO) COSTA RICA Physics Society
Cuban Physics Society CUBA Medical Physics Section
MEXICO Mexican Federation of Organizations for Medical Physics (FMOFM)
PANAMA Panamaniam Association of Physicists in medicine
PARAGUAY Paraguayan Society of Medical Physics
PERU Peruvian Society of Medical Physics
VENEZUELA Venezuelan Society of Medical Physics
Medical Physics OrganizationsEducation
The latinoamerican Association of Medical Physics, Its aims are as follows: -Group Medical physics societies in Latin America and the Caribbean. -To Promote and encourage the training of medical physics societies in Latin America and the Caribbean that do not have adequate training
RADIOTHERAPY Certification and ARGENTINA Education The Nuclear Regulatory Authority extends the permissions to Legislation professionals who meet certain requirements to practice in radiotherapy. This permit is like "Specialists in radiotherapy physics".
REQUIREMENTS -Bachelor's degree in Medical Physics, -Master in Medical Physics or Physics and Engineering (the latter should be in a theoretical course) -Over 1500 hours of clinical practice in no less than one year.
For nuclear medicine ARB extends a similar to Radioterapy permission but "partial" presence is required in the centers of attention. Unfortunately for diagnostic radiology nothing. This depends on the Ministry of Health of the nation and even the presence of specialists not required by diagnostic centers nor are they recognized professionals
Gustavo SAFIM, presented a project to the Ministry of Health, for not recognizing the Sánchez Vicepresident profession of medical physics within the framework of the Health Community. e SAFIM There SAFIM described the requirements, scope and specialties of medical physics.
Rosana Sagsone
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The Brazilian Association of Medical Physics - ABFM, Certification and performs the recognition of qualifications of medical physicists BRASIL LegislationEducation who work in radiotherapy, diagnostic radiology and nuclear medicine, through an annual exam. Recognition is made through the issuing title of Medical Physics Expert in one of three areas: Radiotherapy, Radiology and Nuclear Medicine. The examination for obtaining the Medical Physics Expert Title is held annually and prepared by an exam board composed exclusively for this purpose.
REQUIREMENTS
• To have Bachelor, Bachelor, Master or PhD in Physics or Medical Physics; • Have experience in Medical Physics in the specific area, with the minimum experience
criteria as described below;. • to have had clinical training within the last 2 years..
Radiotherapy: minimum of 3800 hours Diagnostic radiology: minimum of 2850 hours Nuclear medicine : minimum of 2850 hours
Colombian Asociación of Medical Physics and Certification and Radiation Protection Education COLOMBIA Legislation For the first time in 2006, Colombian legislation recognized the need for medical physicists in radiotherapy. They have allotted four years in order to acquire the number of medical physicists needed who will have received adequate training on an international level
Currently , Colombian law requires that those who work in radiotherapy services to have a graduate degree in medical physics and "If you have equipment PET , PET CT have " professionals with expertise in medical physics. " There is no structured certification.
Costa Rica has the peculiarity that the practice is regulated by a College of Physicists
REQUIREMENTS: Years of experience, COSTA RICA Academic status publications , Passing the exam which will be divided into two sections , an oral and a written part . Once submitted and evaluated all these crowded the applicant may be a Medical Physicist Collegiate as an area (RT , RX , MN , RP ) or Specialist Medical Physicist area . Significantly, the College of Physicians is in a phase of analysis to determine the members of an Erik Mora internal committee called COFIMED (Commission of Medical Physics ), which will be responsible Ramirez for start evaluating the skills of these professionals in Medical Physics .
RADIOTHERAPY AND NUCLEAR MEDICINE . Certification and National regulatory authorities ( National Center CNSN the Nuclear Education Safety and Control Center of Drugs, Medical Devices -CECMED ) . Legislation MN and RT . CUBA
REQUIREMENTS:
Specialist Medical -Have the title of Master of Science : Medical Physics and at Physics in NM least six months of supervised work in a Department of MN by an expert and / or possess the Diploma in Nuclear Medicine Physics licensed medical physicist . Specialist in Medical -Have the title of Master of Science : Medical Physics and at Physics at RT least 6 months of work supervised by a licensed expert medical physicist in the Department of Radiotherapy and / or possess the Graduate Radiation Physics .
Another situation presented radiology services that are subject to the regulations of the Ministry of Public Health ( Public Health Ministry ) , which owns less control system certification and licensing requirements . These requirements do not require the presence of a medical physicist in services, although there is a growing awareness of its importance for the safe and best practice of radiological techniques.
They are working on the issue of certification
MsC. Adlin López Díaz
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Certification and Education PANAMA Legislation The operating license granted by the Ministry of Health is the regulatory authority . Professional qualifications to practice as a Medical Physicist is granted under the Ministry of Health Technical Board of Health.
REQUIREMENTS: Master of Medical Physics and two years of residency in the specialty (Radiotherapy , Diagnosis , Nuclear Medicine , Radiation Protection ) .
Medical Physics is registered as Specialty Health Sector at the Ministry of Health.
Fis. Martin Acosta
PERUVIAN INSTITUTE OF NUCLEAR ENERGY(IPEN ) Certification and Education TECHNICAL OFFICE OF THE NATIONAL AUTHORITY (OTAN ) Legislation PERÚ
RADIOTHERAPY (IR.001.01) Basic training : Professional in Physics or Engineering Specialized training : Postgrado In Medical Physics at least two years , Course Training in radiation protection 80 hours at least Teletherapy Practical experience of at least 2 years of work supervised by professionals licensed Adoption of the test applied by OTAN/IPEN DIAGNOSTIC RADIOLOGY ( IR.003.2013 ) Professional graduate of a master's degree in Medical Physics Training or experience of not less than six ( 06) months) Adoption of the test applied by OTAN/IPEN
NUCLEAR MEDICINE (IR.003.2013 ) Basic Training : Professional Specialized training : graduate master's or doctorate in Medical Physics . Practical experience at least 1 year in medical physics tasks in nuclear medicine Adoption of the test applied by OTAN/IPEN
The Ministry of Health (MOH ) is working on the process of official recognition of physical and medical health professional
Certification and Summary : Individual professional certification LegislationEducation There is not standardized program for Training in Medical Physics in Latin America. MP is not recognized as a health professional. The presence of a MP is only mandatory in RT
-To obtain this certification , the candidate should meet the following requirements :
-Have a consistent academic training with any of the modalities
-- Have attained the specific supervised clinical training in the area.
- 'In cases where the country does not have relevant professional bodies , IAEA and / or PAHO could select a group of experts to advise on the certification assessment of the candidate.
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There is no plan (short and long term): The lack of a consistent plan, investments Technological have been done in expensive and complex technologies, some times not in line Education with the facility routine and needs before an analysis of what is really necessary to Equipment improve the quality and level of health services to deliver to the public.
There is no awareness of the importance of creating multi-disciplinary workgroups to plan equipment purchasing, and prioritize expenditures across the facility as a whole. Purchase of medical equipment: out of a plan, in most of cases does not have the participation of experts. Especially in the public sector, the purchase is carried out by the administrative staff without any input.
Proposals Gathering reliable information about the equipment. Planning your technology needs and allocating sufficient funds for them. Purchasing suitable models and installing them effectively. Providing sufficient resources for their use. Operating them effectively and safely. Maintaining and repairing the equipment. Decommissioning, disposing, and replacing unsafe and obsolete items. Ensuring staff have the right skills to get the best use out of your equipment.
THANK YOU!
[email protected] www.spfm.pe www.alfim.net
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